Orthopedic surgeons use screws and similar fasteners in combination with plates and other medical devices for internal fixation and stabilization. Fasteners are useful in the treatment of fractures and in other circumstances such as arthroplasty. Surgeons are generally guided by experience and intuition in performing surgical procedures where screws are tightened, and stop based on “feel.” However, human tissue has variability of mechanical properties, due to age, anatomic location, bone density, nutrition, load history, and numerous other reasons. Stripping of the bone or screw or fastener malposition can lead to unstable fixation and a reduction in treatment effectiveness. Consequences include increased reoperation rates, morbidity, and mortality. Studies using synthetic bone indicate that surgeons may strip the tissue (cause yield, fracture, or failure due to over-torquing) up to 40% of the time when driving screws into tissue at torque levels relevant for fixing osteoporotic bone.